通过识别、确认和等效潜在因素结构优化基线和脑震荡后评估:NCAA DoD CARE联盟的研究结果。

IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Clinical Neuropsychologist Pub Date : 2024-07-01 Epub Date: 2023-10-19 DOI:10.1080/13854046.2023.2271614
Landon B Lempke, Adrian J Boltz, Gian-Gabriel P Garcia, Reid A Syrydiuk, Himadri S Pandey, Paul F Pasquina, Michael A McCrea, Thomas W McAllister, Steven P Broglio
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引用次数: 0

摘要

目的:脑震荡评估使用多维评估来评估独特的患者功能维度(例如,主观症状与平衡评估不同),但总体潜在因素结构尚未得到实证证实。我们的目的是确定受伤前基线和急性(方法:大学生运动员在基线(n = 21865)和脑震荡后(n = 1537)完成了标准化评估。使用基线和脑震荡后评估中的个别项目,包括:运动性脑震荡评估工具、简要症状清单-18、脑震荡标准化评估、平衡误差评分系统、脑震荡后即时评估和认知测试,以及前庭眼运动筛查。对一半的基线数据进行探索性因素分析,对其余基线数据和脑震荡后数据分别进行验证性因素分析。评估性别、运动接触分类、脑震荡史和时间之间的测量等效性。结果:建立了一个10因素探索性模型,包括:抑郁、躯体、前庭-眼部、头痛、姿势稳定性、神经认知、情绪、疲劳、认知、意识模糊。10因素模型在基线和脑震荡后得到证实,时间点之间的测量具有很强的等效性。在两个时间点分别观察到性别、运动接触分类和脑震荡史的强到严格的测量等效性。结论:我们的研究结果在健康和脑震荡的大学生运动员中建立了一个跨时间点和常见因素的稳健的10因素潜在因素模型。临床医生可以利用这些发现来针对特定因素,同时减少冗余因素,以提供有效、全面的脑震荡后评估。
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Optimizing baseline and post-concussion assessments through identification, confirmation, and equivalence of latent factor structures: Findings from the NCAA-DoD CARE Consortium.

Objective: Concussion evaluations use a multidimensional assessment to evaluate unique patient function dimensions (e.g., subjective symptoms differ from balance assessments), but the overarching latent factor structure has not been empirically substantiated. Our objective was to determine the cumulative latent factor structure of pre-injury baseline and acute (<48-h) post-concussion assessment battery outcomes, and determine measurement equivalence among common factors in collegiate student-athletes. Methods: Collegiate student-athletes at baseline (n = 21,865) and post-concussion (n = 1,537) across 25-institutions completed standardized assessments. Individual items were used from the baseline and post-concussion assessments and consisted of: Sport Concussion Assessment Tool, Brief Symptom Inventory-18, Standardized Assessment of Concussion, Balance Error Scoring System, Immediate Post-Concussion Assessment and Cognitive Test, and vestibular-ocular motor screening. Exploratory factor analysis was used on half the baseline data, and confirmatory factor analysis on the remaining baseline data and post-concussion data separately. Measurement equivalence was assessed between sex, sport contact classification, concussion history, and time. Results: A 10-factor exploratory model was established and comprised of: depression, somatic, vestibulo-ocular, headache, postural stability, neurocognition, emotional, fatigue, cognitive, consciousness clouding. The 10-factor model was confirmed at baseline and post-concussion with strong measurement equivalence between timepoints. Strong to strict measurement equivalence was observed for sex, sport contact classification, and concussion history at both timepoints separately. Conclusion: Our findings established a robust 10-factor latent factor model equivalent across timepoints and common factors among healthy and concussed collegiate athletes. Clinicians can use these findings to target specific factors while reducing redundant elements to provide efficient, comprehensive post-concussion assessments.

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来源期刊
Clinical Neuropsychologist
Clinical Neuropsychologist 医学-临床神经学
CiteScore
8.40
自引率
12.80%
发文量
61
审稿时长
6-12 weeks
期刊介绍: The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.
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